Metabolic disease may result in various conditions including obesity, hypertension, diabetes, coronary artery disease, stroke, congestive heart failure, multiple orthopedic problems, pulmonary insufficiency, sleep apnea, infertility, and markedly decreased life expectancy. Additionally, the complications or co-morbidities associated with metabolic disease may affect an individual's quality of life. Accordingly, the monetary, physical, and psychological costs associated with metabolic disease may be substantial in some cases.
A variety of bariatric surgical procedures have been developed to treat complications of metabolic disease, such as obesity. One such procedure is the Roux-en-Y gastric bypass (RYGB). In a RYGB procedure, a small stomach pouch is separated from the remainder of the gastric cavity and attached to a re-sectioned portion of the small intestine. However, because this complex procedure may require a great deal of operative time, as well as extended and painful post-operative recovery, the RYGB procedure is generally only utilized to treat people with morbid obesity.
In view of the highly invasive nature of the RYGB procedure, other less invasive bariatric procedures have been developed such as the Fobi pouch, bilio-pancreatic diversion, gastroplasty (“stomach stapling”), vertical sleeve gastrectomy, and gastric banding. In addition, implantable devices are known which limit the passage of food through the stomach. Gastric banding procedures, for example, involve the placement of a small band around the stomach near the junction of the stomach and the esophagus to restrict the passage from one part of the digestive tract to another, thereby affecting a patient's feeling of satiety.
While the above-described bariatric procedures may be used for the treatment of morbid obesity, in some cases the risks of these procedures may outweigh the potential benefits for the growing segment of the population that is considered overweight. The additional weight carried around by these persons may still result in significant health complications, but does not necessarily justify more invasive treatment options. However, because conservative treatment with diet and exercise alone may be ineffective for reducing excess body weight in some cases, there is a need for treatment options that are less invasive and lower cost than the procedures discussed above.
It is known to create cavity wall plications through both laparoscopic and endoscopic procedures. Laparoscopic plication techniques can be complicated and complex, however, as one or more surgical entry ports may need to be employed to gain access to the surgical site. Furthermore, laparoscopically approaching the stomach may require separating the surrounding omentum prior to plication formation. In endoscopic procedures, plication depth may suffer due to the size restrictions of the endoscopic lumen. For example, the rigid length and diameter of a surgical device are limited based on what sizes can be reliably and safely passed trans-orally into the stomach. Furthermore, access and visibility within the gastric and peritoneal cavities may be progressively limited in an endoscopic procedure as the extent of the reduction increases, because the volume of the gastric cavity is reduced.
In addition, existing devices for forming endoluminal plications may utilize opposing jaws and a grasper element to draw tissue between the jaws. These devices may approach the cavity wall such that a longitudinal axis of the device is perpendicular to the cavity wall. The grasper element can then be advanced from the center of the open jaws, and used to draw tissue between the jaws to create the fold. However, the geometry of these devices limits the size of the plication that can be formed to approximately the length of the jaws, as the grasper may be able to only draw the cavity wall tissue to the center of the jaws and no further. Moreover, in order to secure a plication with a plurality of fasteners, these devices may need to release the tissue and be repositioned anew to apply each fastener. A merely exemplary plication device is disclosed in U.S. Pat. Pub. No. 2013/0153642, entitled “Devices and Methods for Endoluminal Plication,” published Jun. 20, 2013, now U.S. Pat. No. 9,119,615, issued Sep. 1, 2015, the disclosure which is incorporated by reference herein.
While various kinds of bariatric surgical instruments and associated components have been made and used, it is believed that no one prior to the inventor(s) has made or used the invention described in the appended claims.
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.